因素分类描述了疑似早期发作的败血症在多中心NICU抗生素管理协作中的实践变化
Neha S Joshi1, Kenneth M Zangwill2, Henry C Lee3
1Stanford University, Stanford, CA, USA. nsjoshi@stanford.edu.
概括
在新生儿怀疑早发性败血症的提供者实践在抗生素管理合作期间得到改善. 实验室测试的订单减少了,处方变得更加管理友好.
科学领域:
- 新生儿医学 新生儿医学
- 传染性疾病 传染性疾病
- 临床药房 临床药房
背景情况:
- 孕期婴儿早期发作的败血症 (EOS) 需要谨慎的抗生素管理.
- 对于疑似EOS的抗生素使用,提供者实践存在差异.
- 抗生素管理计划旨在优化抗菌素处方.
研究的目的:
- 评估医疗服务提供者对怀疑有EOS的分娩婴儿的治疗实践偏好.
- 评估这些偏好随着时间的推移而发生的变化,在多中心抗生素管理协作中进行评估.
主要方法:
- 在基线和经过12个月的质量改进协作后,进行了因子病例小幅调查.
- 受访者包括新生儿重症监护室 (NICU) 的医疗保健提供者.
- 开发了一个管理评分来量化处方做法.
主要成果:
- 应答率在基线时为72% (n=252) 和随访时为55% (n=195).
- 在调查之间观察到,订购实验室测试的可能性显著降低 (p <0.001-0.033).
- 平均管理得分有所改善,表明转向更友好的管理实践 (0.39对0.30).
结论:
- 在抗生素处方实践中的特定变化被确定为NICU改善的目标.
- 在协作干预之后,提供者实践演变为更具抗生素管理友好的方法.
- 案例贴图方法在优化与抗生素处方相关的质量改进工作方面被证明是有效的.
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